4) Given a cruel, negative role model and distorted representations of being a woman and mother

5) Confusion, rejection, and shame concerning her own sexual development as a female

6) Uncertainty over being a mother, and how to appropriately raise and respond to a female child

7) The stigma from society; the lack of information, validation, understanding for this form of abuse

Many survivors of mother-daughter sexual abuse have multiple abusers, both male and female. Regardless, the sexual abuse by their mothers often stands out as the hardest to accept and heal from, and the last abuse experiences to be remembered. The impact of that statement cannot be ignored.